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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-416410

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1. HERZOG CONTRACTING CORP POLITICAL ACTION COMMITTEE

    3760 Kilroy Airport Way
    Suite 120
    Long Beach, CA 90806

    NOTE: Address is different than previously reported

    Email: miker@herzogcompanies.com

    NOTE: Email address is different than previously reported

2. Date: 05/06/2009

3. FEC Committee ID #: C00391979 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Herzog Contracting Corp.
600 S. Riverside Rd.
St. Joseph, Missouri 64507
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Michael Rogers
3760 Kilroy Airport Way
Suite 120
Long Beach, CA 90806
Title: Asst. Treasurer
Phone # (562) 595-7414

Treasurer:

Norman Jester
3760 Kilroy Airport Way
Suite 120
Long Beach, California 90806
Title: Treasurer
Phone # (562) 595-7414

Designated Agent(s):

Banks or Depositories

UMB Bank
2501 Frederick Ave.
St. Joseph, Missouri 64506

Signed: Norman Jester
Date Signed: 05/06/2009

(End FEC FORM 1)

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